Blood Pressure For Pregnant Women

Different Types Of High Blood Pressure In Pregnancy

There are 3 types of high blood pressure during pregnancy:

• Chronic hypertension: This is when you already had high blood pressure before you fell pregnant for example if you already had a medical condition such as kidney disease. Chronic hypertension also refers to when your high blood pressure is diagnosed in the first 20 weeks of pregnancy. Some women with chronic hypertension may develop pre-eclampsia when they are pregnant.
• Pregnancy-induced hypertension: This is high blood pressure that is diagnosed after 20 weeks of pregnancy. It is also called gestational hypertension.
• Pre-eclampsia: Pre-eclampsia is a serious condition that only occurs in pregnant women. As well as high blood pressure, it can also affect the kidneys, liver, blood and brain.

When Should I Call The Doctor About High Blood Pressure During Pregnancy

If you’re checking your blood pressure at home, contact your provider if your blood pressure is above a certain level. Your provider can tell you what those levels should be and what to do if you go above them.

Let your provider know immediately if you notice any changes in your baby’s movements. If your baby seems less active than usual, you may need to do kick counts.

Also call your provider right away if you have any signs of severe preeclampsia or HELLP syndrome:

• A headache that’s severe or doesn’t go away
• Vision changes, including double vision, blurriness, seeing spots or flashing lights, light sensitivity, or temporary loss of vision
• Intense pain or tenderness in the upper abdomen or shoulder
• Nausea or vomiting
• Difficulty breathing

Optimizing Blood Pressure Before Or During Pregnancy

For most women, blood pressure doesn’t rise during pregnancy. In fact, it falls gradually until around 20 weeks, then rises closer to baseline toward the end of pregnancy. Most patients should fall below 120/80 on average and start thinking about treatment at 140/90 or higher, according to ACOG.

If you start pregnancy with elevated blood pressure you may have chronic hypertension that has not yet been diagnosed. So, it makes sense to discuss treatment options with your provider, working together to manage blood pressure early and reduce the risk of maternal or fetal complications.

In general, blood pressure medications are inexpensive and accessible under most types of health insurance. However, it sometimes takes a bit of time for new data to trickle into the clinical setting and replace outdated information online.

If you know you have high blood pressure, talk with your doctor about whether taking antihypertensive medication is right for your pregnancy. If you are already on medications, plan to review those with your provider as there are some that are not appropriate to take during pregnancy. Dont assume you should just stop taking the medication to avoid exposure to your unborn baby. It is your right to bring up any care you think could benefit your health.

The risk of pregnancy complications is never zero. But taking small steps to improve your health such as managing your blood pressure can make a big impact on your outcomes, potentially long after delivery.

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Monitor Your Weight :

Being overweight is a risk factor for hypertension and thus, you need to take caution to keep your pregnancy weight gain within healthy limits. A proper diet and regular exercise are ways to manage your weight gain during pregnancy.

• Preeclampsia is associated with hypertension and weight gain during pregnancy, so it is important to avoid gaining too much weight and to avoid gaining weight too quickly. Preeclampsia can lead to kidney and liver problems for the mother and complications for the baby.
• Being overweight also increases the risk of other health conditions during pregnancy, such as back aches, exhaustion, leg cramps, hemorrhoids, gestational diabetes, heart burn and aching joints.

Through a healthy diet and a proper exercise routine, you can get to a healthy weight. Talk to your doctor about the weight thats right for you and follow the instructions given by your doctor.

Hypertension Canada And Society Of Obstetricians And Gynaecologists Of Canada

Women should have their BP measured using a standardized protocol after a period of rest in a quiet environment and be in a sitting position with their arm at the level of the heart using an appropriately sized cuff .

The arm with higher BP values should be used for hypertension diagnosis and BP monitoring.

Nonsevere elevated BP should be remeasured at the same visit, with at least a gap of 15 minutes from the first measurement.

More than 50% of women with a first BP reading of 140/90 mm Hg have white-coat effect.

Hypertension in pregnancy is defined as an SBP 140 mm Hg and/or a DBP 90 mm Hg .

Severity of hypertension in pregnancy is considered on the basis of the presence of target organ involvement as well as the actual BP level.

BP levels between 140/90 mm Hg and < 160/110 mm Hg are considered nonsevere hypertension in pregnancy.

A BP level of 160/110 mm Hg is associated with increased risk of maternal stroke in pregnancy and is therefore considered the diagnostic threshold of severe hypertension in pregnancy.

Antihypertensive therapy is recommended for average SBP measurements of 140 mm Hg or DBP measurements of 90 mm Hg in pregnant women with chronic hypertension, gestational hypertension, or preeclampsia.

Initial antihypertensive therapy should be monotherapy from the following first-line drugs: oral labetalol, oral methyldopa, long-acting oral nifedipine, or other oral -blockers .

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Risk Factors For High Blood Pressure In Pregnancy

There are many factors that can put you at risk for developing high blood pressure during pregnancy. Knowing these risk factors ahead of time can help you and your provider develop a treatment plan or prevention plan for high blood pressure during pregnancy.

Some risk factors for high blood pressure in pregnancy include:

• Being overweight
• Family history of high blood pressure
• Diabetes or kidney disease
• A sedentary lifestyle

These risk factors put you at greater risk of developing high blood pressure during pregnancy, which can lead to pregnancy complications.

Some complications that can result from high blood pressure during pregnancy include:

• Placenta abruption

How To Prevent High Blood Pressure During Pregnancy

Some risk factors can’t be changed, such as your genes or having certain health conditions. But you can make changes to reduce other risk factors, and these are important to know about when you’re trying to get pregnant.

Some steps you can take to reduce your high blood pressure risks:

• Maintain a healthy weight and diet. Talk to your provider about how much weight to gain during pregnancy. The DASH diet has been shown to lower blood pressure and cholesterol.
• Ask your provider if it’s safe to exercise. In most cases you can continue to exercise, though your provider may recommend modifying the types of activities you do.
• Manage stress, which can worsen high blood pressure

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If Youre At High Risk For Preeclampsia Your Provider May Want You To Take Low

What is high blood pressure?

Blood pressure is the force of blood that pushes against the walls of your arteries. Arteries are blood vessels that carry blood away from your heart to other parts of the body. Each time your heart beats, it pumps blood to the arteries. If the pressure in your arteries becomes too high, you have high blood pressure . High blood pressure can put extra stress on your organs. This can lead to heart attack, heart failure, stroke and kidney failure.

Some women have high blood pressure before they get pregnant. Others have high blood pressure for the first time during pregnancy. About 8 in 100 women have some kind of high blood pressure during pregnancy. If you have high blood pressure, talk to your health care provider. Managing your blood pressure can help you have a healthy pregnancy and a healthy baby.

How do you know if you have high blood pressure?

Your blood pressure reading is given as two numbers:

Systolic blood pressure. This is the upper number in your reading. Its the pressure when you heart contracts . Your blood pressure is highest when your heart beats and pumps blood.

Diastolic blood pressure. This is the lower number in your reading. Its the pressure when your heart relaxes. Your blood pressure falls because your heart is at rest between beats.

Your blood pressure reading fits into one of five categories:

Normal. Your blood pressure is less than 120/80.

What pregnancy complications can high blood pressure cause?

What Are Normal Blood Pressure Changes In Pregnancy

A baby receives all its food and oxygen from the mother. This means that your heart has to work harder to send blood to the placenta and then to your baby.

The placenta usually has large blood vessels that make it easy for the food to get to your baby. Because these blood vessels are so big, your blood pressure normally drops during the middle third of your pregnancy and returns to normal by the end of the pregnancy.

If your blood pressure is too high during pregnancy, this may indicate that the blood vessels in the placenta have not developed normally. This is a risk to you and your baby, as it can be a sign of a serious complication known as pre-eclampsia.

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High Blood Pressure Treatment In Pregnancy Is Safe Prevents Maternal Heart Risks

Statement Highlights:

• High blood pressure during pregnancy remains a major cause of maternal and fetal pregnancy-related complications and death, and it increases womens short- and long-term risks for cardiovascular disease.
• Emerging data from clinical trials and observational research support the benefits and safety of blood pressure treatment during pregnancy.
• Continued investigation is critical to determine which blood pressure levels, during- and post-pregnancy, both for starting therapy and as treatment goals, are beneficial for the mother and safe and beneficial for the fetus.
• The statement advises multidisciplinary, team-based personalized care where clinicians partner with the patient to determine preferred treatment and consider the risks for hypertension-related adverse outcomes

Embargoed until 4 a.m. CT / 5 a.m. ET Wednesday, Dec. 15, 2021

DALLAS, Dec. 15, 2021 Treatment for high blood pressure during pregnancy appears safe for many women and may reduce maternal risk for severe hypertension without increasing fetal and neonatal risks, according to a new American Heart Association scientific statement published today in the Associations journal Hypertension.

The goals of treatment during pregnancy include preventing severe hypertension and preventing early delivery to allow the fetus time to mature before delivery.

The statement also highlights these areas of concern:

Additional Resources:

Why Is High Blood Pressure During Pregnancy A Problem

The main risk of having high blood pressure during pregnancy is developing pre-eclampsia. Pre-eclampsia is a serious condition and it can affect both you and your baby. Read more about pre-eclampsia.

If your blood pressure remains mildly to moderately raised and you dont develop pre-eclampsia, the risk of pregnancy complications is low. However, it is important that your blood pressure and urine are checked regularly throughout your pregnancy to check for signs of pre-eclampsia.

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How To Lower Your High Blood Pressure During Pregnancy

High blood pressure and pregnancy isnt necessarily a dangerous combination. But having hypertension during pregnancy requires special care, irrespective of whether you are diagnosed with this problem before or after conception.

High blood pressure, medically known as hypertension, means the force of the blood that pushes against the walls of your arteries is too high. Blood pressure readings of 140/90 mm Hg is considered too high.

While hypertension can affect anyone, pregnant women are at an increased risk. According to the Centers for Disease Control and Prevention, an increasing number of pregnant women in the United States suffer from hypertension. In fact, according to the American Pregnancy Association, high blood pressure affects about 6 to 8 percent of pregnant women.

Normal Blood Pressure For Children

Normal BP ranges vary in children by age. The University of Iowa Stead Family Childrens Hospital provides this blood pressure chart:

Normal Blood Pressure for Children
Systolic
112128 mm Hg	6680 mm Hg

What is considered healthy for your child also varies by height, age, and sex. You can use Baylor College of Medicine’s calculator to see if your childs blood pressure reading is in a healthy range.

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If High Blood Pressure Remains Mild And Pre

There is usually little risk. You will be advised to take 75-150 mg aspirin daily from 12 weeks of pregnancy. Regular checks of your blood pressure and your urine for protein, as well as checks to see how your pregnancy is progressing, may be all that is needed until the natural time of birth. Checks may include blood tests and an ultrasound scan to look at how your baby is growing and to check the blood flow from the afterbirth to the baby. You may be followed up by an obstetrician. You may need medicines to control your blood pressure during your pregnancy. You may be offered a placental growth factor blood test to help rule out pre-eclampsia between 20 weeks and up to 35 weeks of pregnancy, if you are suspected of developing pre-eclampsia.

What Are Types Of High Blood Pressure Conditions Before During And After Pregnancy

Your doctor or nurse should look for these conditions before, during, and after pregnancy:1,11

Chronic Hypertension

Chronic hypertension means having high blood pressure* before you get pregnant or before 20 weeks of pregnancy.1 Women who have chronic hypertension can also get preeclampsia in the second or third trimester of pregnancy.1

Gestational Hypertension

This condition happens when you only have high blood pressure* during pregnancy and do not have protein in your urine or other heart or kidney problems. It is typically diagnosed after 20 weeks of pregnancy or close to delivery. Gestational hypertension usually goes away after you give birth. However, some women with gestational hypertension have a higher risk of developing chronic hypertension in the future.1,12

Preeclampsia/Eclampsia

Preeclampsia happens when a woman who previously had normal blood pressure suddenly develops high blood pressure* and protein in her urine or other problems after 20 weeks of pregnancy. Women who have chronic hypertension can also get preeclampsia.

Preeclampsia happens in about 1 in 25 pregnancies in the United States.1,13 Some women with preeclampsia can develop seizures. This is called eclampsia, which is a medical emergency.1,11

Symptoms of preeclampsia include:

Some women have no symptoms of preeclampsia, which is why it is important to visit your health care team regularly, especially during pregnancy.

You are more at risk for preeclampsia if:1

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Low Blood Pressure Complications

While many women who have low blood pressure prior and during pregnancy do not have any related issues, there are some complications to be aware of.

Some symptoms of low blood pressure include:

• Rapid or shallow breathing

One of the most concerning complications is dizziness because it can lead to fainting, falling, and injury, secondary to the fall. Additionally, research has shown a link between low blood pressure and increased symptoms of morning sickness.

High Blood Pressure Risks In Pregnancy

Hypertension that occurs during pregnancy complicates up to 10% of all pregnancies. There can be very serious complications to you or your baby when you have high blood pressure in pregnancy. Preeclampsia is a condition that occurs only during pregnancy and involves new onset of high blood pressure in pregnancy, usually after 20 weeks. If you do not have protein in the urine, this condition is usually referred to as gestational hypertension if you have protein in the urine it is referred to as preeclampsia.

Women who are having their first baby, have had preeclampsia in a previous pregnancy, have chronic hypertension, are having twins or triplets, are pregnant from in-vitro fertilization, are older than 40, or have diabetes are all at a higher risk for developing high blood pressure in pregnancy. For this reason, it is important to attend your prenatal visits. Your doctor may order additional blood and urine tests to help you have a successful pregnancy.

The treatment for preeclampsia at full term is to deliver your baby, which will improve your health. However, that is not always the safest plan for the health of the baby. When these conditions develop too early in pregnancy, your OB provider will decide a treatment plan, which could include outpatient or inpatient observation, blood work or delivery. Medications to help lower your blood pressure may also be recommended.

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What Are The Different Forms Of High Blood Pressure During Pregnancy

High blood pressure complicates about 10 percent of all pregnancies. There are several different types of high blood pressure during pregnancy. These types vary in severity and impact on the body. The forms of high blood pressure during pregnancy include:

• Chronic hypertension: High blood pressure which is present prior to pregnancy.
• Chronic hypertension with superimposed preeclampsia: Preeclampsia, which develops in someone who has chronic hypertension .
• Gestational hypertension: High blood pressure is noted in the latter part of pregnancy, but no other signs or symptoms of preeclampsia are present. Some women will later develop preeclampsia, while others probably have high blood pressure before the pregnancy.
• Preeclampsia: A condition only found in the latter half of pregnancy and results in hypertension, protein in the urine, and generalized swelling in the mother. It can impact other organs in the body and also cause seizures .

Tracking Blood Pressure During Pregnancy

A blood pressure reading is a fraction: your systolic blood pressure over your diastolic blood pressure.

The top number is your systolic pressure, which is a measurement of the pressure on your arteries when the heart is beating or squeezing blood forward through your body.

The diastolic pressure, or the lower number, is a measurement of the blood pressure in your arteries when the heart is at rest.

To determine what your normal blood pressure is during pregnancy, your doctor will likely take a baseline blood pressure measurement at your first visit. Then they will measure your blood pressure at every visit that follows.

Normal blood pressure is anything less than 120/80 mm Hg.

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